A 30 year old male presents with a stab wound to the abdomen. BP is 85/60, HR 130, RR 26 and GCS 14. Neck veins are flat and chest examination is clear with bilateral breath sounds. Optimal resuscitation should include:

Correct Answer: B

Rationale: The correct answer is B: "Preparation for laparotomy while initiating fluid resuscitation." In this scenario, the patient is hemodynamically unstable with signs of hypovolemic shock. The priority is to address the source of bleeding, which is likely intra-abdominal due to the stab wound. Therefore, preparing for a laparotomy to control the bleeding is crucial. Fluid resuscitation should be initiated to stabilize the patient's hemodynamics and improve tissue perfusion. This approach addresses the immediate life-threatening issue and is the most appropriate course of action to prevent further deterioration. Explanation for other choices: A: "Transfusion of FFP and platelets" - This option does not address the immediate need for controlling bleeding and stabilizing the patient's hemodynamics. C: "Resuscitation with crystalloid and pRBC until base excess is normal" - While fluid resuscitation is necessary, waiting for base excess to normalize may delay definitive treatment and compromise the

Correct Answer: D

Rationale: The correct answer is D because when a nursing assistant is suspected of abuse, it is crucial to prioritize the safety and well-being of the residents. Suspending the nursing assistant immediately helps protect residents from potential harm and allows for a thorough investigation to be conducted without interference. This ensures that the situation is addressed promptly and appropriately. A: Holding a meeting with staff members and residents may compromise the investigation and confidentiality. B: Allowing the nursing assistant to continue working can put residents at risk and hinder the investigation process. C: Revealing the name of the person who reported the abuse can discourage others from coming forward and breach confidentiality. In summary, choice D is the correct step to take in such a situation to ensure resident safety, conduct a fair investigation, and maintain confidentiality.

Correct Answer: D

Rationale: The correct answer is D because a nursing assistant's report may trigger a needed assessment for a resident. This is true as nursing assistants often have direct contact with residents and may notice changes or issues that require further evaluation. This process helps ensure that residents receive appropriate care and interventions in a timely manner. Explanation for why other choices are incorrect: A: MDS stands for Minimum Data Set, not Multiple Diagnosis System. B: Completion of an MDS does not automatically trigger a state investigation. C: While most residents in long-term care facilities will have an MDS, it is not true that all residents will have one.

Correct Answer: D

Rationale: The correct answer is D: Never. Hitting a resident is never appropriate in any situation as it goes against the ethical principles of nursing care. Nursing assistants are responsible for providing care with compassion and respect, and physical violence is unacceptable. It is important to always prioritize the safety and well-being of residents. Choices A, B, and C are incorrect because resorting to violence is never justified, regardless of the circumstances. Encouraging peaceful conflict resolution and seeking help from supervisors or authorities are more appropriate actions in these scenarios.

Correct Answer: A

Rationale: The correct answer is A: Systemic infection. When pathogens enter the bloodstream and spread throughout the body, it results in a systemic infection affecting multiple organs or systems. This type of infection can lead to severe illness and requires immediate medical attention. Choice B: Localized infection is incorrect because it refers to an infection that is confined to a specific area of the body, not spreading through the bloodstream. Choice C: Healthcare-associated infection is incorrect as it relates to infections acquired in healthcare settings, not specifically referring to the spread of pathogens through the bloodstream. Choice D: Cross-infection is incorrect because it typically refers to the transmission of infections between individuals, not the movement of pathogens through the bloodstream causing a systemic infection.